What about blood pressure fluctuation after dosing with Dexmedetomidine in patients with pre-surgical hypertension / hypotension?
a. Presurgical Hypertension The Dexmedetomidine pivotal studies for US approval (W97-245 and W97-246), as well as the Dexmedetomidine Japanese bridging study (J-DEX 99-001) all permitted subjects with preoperative hypertension to be enrolled and receive Dexmedetomidine. Subjects with a variety of antihypertensive medications were enrolled in these investigations. There have been no clinical reports of any particular class of antihypertensive predisposing to hypotension when given with Dexmedetomidine. Beta blockers (specifically, esmolol) have been specifically studied with Dexemedetomidine and have been found to not increase the risk of either hypotension or bradycardia [iI]. Calcium channels blockers (isradipine) may augment any potential Dexmedetomidine-associated hypotension, since they appear to block the peripheral vasoconstrictive alpha-2b effect that normally balances the central sympatholytic alpha-2a effect [iii]. b. Presurgical Hypotension Any disease state predisposing to l
